Report on Breast Cancer Awareness Among South Asian Women in the UK

This report examines breast cancer awareness among South Asian women in the UK, a group with a disproportionately high prevalence rate. It highlights the critical need for improved education and access to care due to factors like language barriers, limited health literacy, and cultural considerations. The report details awareness strategies implemented in schools and community colleges across major UK cities, focusing on educating women about cancer's nature, early signs and symptoms, and the importance of screening. It also addresses the characteristics of the South Asian community in the UK, health improvement issues, service provision, and the role of nurses in promoting awareness and early detection. The report emphasizes the need for culturally sensitive and linguistically appropriate interventions to improve breast cancer outcomes for South Asian women in the UK. Desklib is a platform where students can find similar solved assignments and past papers.

Running head: BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMEN IN UK
Name of the Student
Name of the University
Author’s Note:

1BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
Executive summary:
Breast cancer has been reported to be the most prevalent cancer types in the United Kingdom
with the prevalence rate being the highest among South Asian women. Lack of education and
awareness about breast cancer has served to be a major obstacle that hinders access to care
facilities among the South Asian Women. This report contains five chapters. The first four
chapters cover Characteristics of the geographical community, Health improvement issue,
Service provision and the role of the nurses. The final and fifth chapter is for summary and
conclusion. The This report details the strategies undertaken to impart awareness among the
South Asian women in one popular school and community college across six major cities of
UK that include, Manchester, Birmingham, Sheffield, Bristol and Nottingham. The
awareness strategies typically comprise of imparting education about the nature of cancer,
paying attention to the initial signs and symptoms and opting for mandatory screening so as
to ensure initial identification of breast cancer.

2BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
Table of Contents
Introduction................................................................................................................................3
Chapter 1 - Characteristics of the geographical community......................................................4
Chapter 2 – Health improvement issue......................................................................................8
Chapter 3: Service Provision....................................................................................................11
Chapter 4: The role of the Nurses............................................................................................14
References................................................................................................................................19
Appendix 1...............................................................................................................................23

3BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
Introduction
Globalisation has made many 1st world countries a multi- communal living place and United
Kingdom is no exception to this context. Nine percent of United Kingdom’s total population
is comprises of ethnic minority communities and almost half them minorities communities
are from Indian subcontinent (Wohlandet al. 2010). Community plays a major role in case of
disease awareness and prevention of any particular disease. Communities can be of two types
which are known as interest community and geographic community. In this report, disease
awareness program for a geographic community in the United Kingdom will be discussed.
Geographic community can be defined as a community which is demarcated over a common
geographic space. There might be a common social interaction or tie present amongst the
individual in that said community (Poland and Maré 2005). The geographic community that
will be discussed and analysed in this article is the women living in United Kingdom from
South Asia. Studies have suggested that most common type of cancer in United Kingdom is
breast cancer. The incidence rate of breast cancer is increasing among the South Asian
women. Many of the woman from South Asia is multilingual; however they can only read
their mother tongue(Wohlandet al. 2010). As a direct consequences, breast cancer awareness
and screening amongst them is very low and there is anurgent need for raising awareness
amongst this community. Therefore, in this article, community profile of South Asian
woman, health issues amongst them, service provision, and role of nurses in such case will be
discussed for the disease breast cancer in the following chapter.

4BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
Chapter 1 - Characteristics of the geographical community
Community profile: South Asian people are the largest ethnic minority community in
United Kingdom which comprises up to 9 per cent of the total British population. Nearly, half
of the South-Asian population belongs to the Indian sub- continent (Wohlandet al. 2010).
This large per cent is mainly due to the reason of large scale immigration from South Asia
which started in the year of 1950s and hiked in the year of 1960s and 1970s (Farooq and
Coleman 2005). As a direct consequence, few south Asian women over the age of 60 were
born in the United Kingdom (Farooq and Coleman 2005). Unsurprisingly, incidence rate of
breast cancer amongst these woman are almost same as the breast cancer incidence rate
within the Indian sub- continent. However, awareness of breast cancer is very low amongst
the women from south Asian people.
Justification for chosen disease and community: Cancer is one of leading malignant
disease in the United Kingdom. Amongst cancer, breast cancer is the most commonly
occurring disease amongst the British woman in United Kingdom. Breast cancer constitutes
almost 20 per cent of all cancer related deaths among the British woman (dos Santos Silva et
al. 2003). Unfortunately, there is still no cure for the cancer. The only process of treating
cancer is awareness, early detection and prevention. To achieve this goal, awareness is
paramount amongst the individuals within a community. It has been observed that lack of
awareness about breast cancer is very much persistent amongst the South Asian woman.
Hence, raising awareness for breast cancer amongst the South Asian woman has been chosen
as the awareness topic for this article.
Characteristics: Asian or British Asian makes the biggest ethnic community in the United
Kingdom and Wales. According to the 2011 census report, almost 7 to 8 per cent of total
United Kingdom population belongs to the people from South Asian region (Ons.gov.uk

5BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
2019). Amongst them, Indian people have the largest share, followed by Pakistanis and
Bangladeshis respectively. Indian population percentage is 2.5 per cent, followed by
Pakistanis with 2 per cent (Ons.gov.uk 2019). Bangladeshis comprises of around 0.75 per
cent of the total South Asian ethnic population (Ons.gov.uk 2019). Asian individuals from
other countries comprises of almost 1.5 per cent of the people (Ons.gov.uk 2019). 1.4 million
people culturally and ethnically belongs from India and international migration report from
2011 census data showed that the individual from south Asian countries which are India,
Pakistan and Bangladesh continuing to be growing higher (Ons.gov.uk 2019). From the 2011
census data, it can be seen that ethnic citizens from India have grown 2.5 per cent from 2 per
cent in the last decade whereas ethnic citizens from Pakistan have grown almost 0.6 per cent
in the last decade (Ons.gov.uk 2019). Table 1 below shows the per cent of Asian ethnic
population present in the various region of the United Kingdom and Wales.
Table 1: Asian ethnic population present in the various region of the United Kingdom
and Wales.
Region Asian/Asian British
England and Wales 7.5
North East 2.9
North West 6.2
Yorkshire and the
Humber
7.3
East Midlands 6.5
West Midlands 10.8
East of England 4.8
London 18.5
South East 5.2
South West 2.0
Wales 2.3
Source: (Ons.gov.uk 2019)
From the above table, it can be seen that the largest population from Asia concentrated in the
London municipal area followed by West Midlands and Yorkshire and the Humber. Almost
18.5 per cent of total population lives in London and amongst them 6.6 per cent are Indian

6BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
(Ons.gov.uk 2019). However, in the West Midlands area, highest population is belongs to the
Pakistanis which are 4.1 per cent, followed by Indian which is 3.9 per cent (Ons.gov.uk
2019).
Age structure of the South Asian people is depicted in the following image. Figure 1 shows
the age structure of the people from Indian, Pakistan and Bangladeshi background.
Figure 1: the age structure of the people from Indian, Pakistan and Bangladeshi
background
Source: (Cpa.org.uk, 2019)
From the above figure, it is clear that maximum people who are belongs in this community
are aged below 15 years old followed by the people who are between 50 to 60 years old
(Cpa.org.uk, 2019).

7BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
The life expectancy and mortality rate of the people in the south Asian community is in per
with the other community in the United Kingdom. The mortality for the male in this
community is around 75 years whereas mortality for the females in this community is around
80 years old (Cpa.org.uk, 2019). From this data it is evident that females in the south Asian
community have higher life expectancy than males (Cpa.org.uk, 2019).
Studies have shown that people belong in the south Asian community tends to suffer from
obesity related disease more than any other community. Other than genetic factors, lifestyle
choices of the people are also strongly associated with this risk and risk factor for this
smoking, diet, depression and stress (Lucas, Murray and Kinra 2013).

8BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
Chapter 2 – Health improvement issue
Health improvement can be defined as a work being done to improve the well being and
health of a particular community through awareness, enabling and encouraging healthy
lifestyle choices by addressing the risk factors such as poverty, unemployment and lack of
educational opportunities. Keeping that in mind, breast cancer awareness program amongst
south Asian women was chosen for this report because it is quite well documented that there
is very poor breast cancer awareness amongst them. There are various reason behind this
health problem. The reasons are:
 Unavailability of language specific information as most them cannot read except their
mother tongue
 Lack of general health literacy
 Unavailability of culturally specific information (Jain et al. 2010).
This health issue amongst the south Asian woman needs to be addressed as they are very
much susceptible and prone to the higher incidence of symptomatic presentation amongst the
younger women in the south Asian community. To tackle this issue, breast screening has to
be performed amongst them, but sadly, the screening rate remains low amongst the women in
this community particularly amongst Bangladeshi and Pakistani women. This can be
attributed to the religion belief of them, social stigma and lack of knowledge amongst them.
The only way to tackle this issue effectively is to raise awareness amongst them and provide
information about the harmfulness and severity of breast cancer. Another issue is that the lack
of translated material. As mentioned above, most of them cannot read except in their mother
tongue even if they are multilingual. Lack of communication and information gap created due
to this particular reason. It has been reported that this screening rate is even lower where this
ethnicity combined with deprivation or poverty. Therefore, it can be stated that poverty or

9BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
deprivation plays a significant role in case of the awareness regarding breast cancer. This
scenario is particularly true in case of some small town in northern England and inner city
areas. In a nutshell, NHSBSP or National Health Service Breast Screening program has very
meagre communication with the community of South Asian people. Even the freely provided
translated material regarding breast cancer information was not fully utilised. Although, this
is due to the lack of awareness amongst south Asian people, very little effort has been made
to provide information to the people who came to National Health Service Breast Screening
program.
Women in the south Asian community have familiar Nottingham Prognostic score when
diagnosed cancer at the time of screening. This score is based on historical parameters.
Studies have shown that the Pakistani and Indian women in the United States of America
have more progesterone receptor (PR) and oestrogen receptor (ER) negative tumours in
comparison with their Caucasian counterpart. In comparison with their Caucasian
counterpart, Indian and Pakistani women are much more prone to inflammatory cancer
(Kakarala et al. 2010). Another common histology amongst them is that invasive ductal
carcinoma. Studies have also showed that 17 per cent of patient diagnosed with breast cancer
have been found to have over expression of HER-2neu immune- reactivity rate. In brief,
women with the age of less than thirty five years were presented with larger tumours. These
women are also more likely to be having negative ER and have a chance of higher grade of
cancer (Leong et al. 2010).
Studies have reported that women from Indian sub continent have less incidence rate
compared to women from United Kingdom (Nandakumar et al. 2001). However, south Asian
women living in United Kingdom have significantly higher incidence rate compared to them.
This rate is 64.6 per 100,000 women (Nandakumar et al. 2001). Researchers have suggested
that this difference in incidence rate might be because of change in life style in United

10BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
Kingdom with comparison Indian sub continent. These life style changes can be noted as
shorter breast feeding period, fewer number of children, marriage and conceive of first child
in later part life and other environmental risk factors. Table 2 below will depict the diagnosed
breast cancer for Asian and Caucasian in England and the age at diagnosis.
Table 2: Individual diagnosed with breast cancer in Caucasian and Asian ethnicity in
England and the age at the time of diagnosis.
Ethnicity of the
patients
Total Cases
Age at Diagnosis (Median,
Interquartile Range)
Women aged 50-70
Numb
er % No.
Screen-
detected
(%)
Caucasian 26,807 64.6% 62 (52-72) 14,500 56.3%
Asian 611 1.5% 55 (47-65) 359 52.1%
Source: (Ncin.org.uk 2019)
From the above table, it can be seen that the Asian patients have been diagnosed at earlier age
than their Caucasian counterparts and the percentage of screen detection is almost equal for
both the group. So, form this table, it can be said that Asian individual are susceptible to
breast cancer at earlier age.
From the above data, it can be deduced that south Asian women have lower prognostic
outcome, however limited treatment options have been availed by them due lack of
awareness or diagnosed at later stage of cancer. Therefore, even though south Asian women
have lower incidence rate of breast cancer, the mortality rate higher compared to other

11BREAST CANCER AWARENESS AMONGST SOUTH ASIAN WOMAN
community. This can be prevented by better awareness and hence, there is a paramount need
breast cancer awareness amongst the women in South Asian community.